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Effect of Hydrophilic Components of the Extracellular Matrix on Quantifiable Diffusion-Weighted Imaging of Human Gliomas: Preliminary Results of Correlating Apparent Diffusion Coefficient Values and Hyaluronan Expression Level

Niloufar Sadeghi1, Isabelle Camby2, Serge Goldman3, Hans-Joachim Gabius4, Danielle Balériaux1, Isabelle Salmon5, Christine Decaesteckere2, Robert Kiss2 and Thierry Metens1

1 Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, 808, Route de Lennik, 1070, Brussels, Belgium.
2 Laboratory of Histopathology, Hôpital Erasme, Faculty of Medicine, Université Libre de Bruxelles, 1070, Brussels, Belgium.
3 PET/Biomedical Cyclotron Unit, Hôpital Erasme, Université Libre de Bruxelles, 1070, Brussels, Belgium.
4 Institute of Physiological Chemistry, Ludwig-Maximilians University, 13, Veterinarstraat, 80539 Munich, Germany.
5 Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles, 1070, Brussels, Belgium.



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  		Fig. 1A. —37-year-old man with low-grade oligodendroglioma. Axial fluid-attenuated inversion recovery MR image (TR/TE, 6500/150; inversion time, 2100 msec) shows area of high signal intensity in right frontal lobe with mass effect.

 


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  		Fig. 1B. —37-year-old man with low-grade oligodendroglioma. Contrast-enhanced axial T1-weighted spin-echo MR image (422/9) obtained at same level as A shows that lesion is of low signal intensity and does not enhance.

 


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  		Fig. 1C. —37-year-old man with low-grade oligodendroglioma. Axial diffusion-weighted MR image (b = 1000 sec/mm2) shows that lesion is moderately hyperintense and contours of lesion are not well delineated.

 


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  		Fig. 1D. —37-year-old man with low-grade oligodendroglioma. Axial apparent diffusion coefficient (ADC) map of corresponding axial diffusion-weighted image (C) shows that lesion appears slightly hyperintense. Also shown is one area of interest () where ADC has been measured.

 


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  		Fig. 2A. —73-year-old man with glioblastoma. Axial T1-weighted MR image (TR/TE, 422/9) shows left frontal mass of hyposignal intensity.

 


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  		Fig. 2B. —73-year-old man with glioblastoma. Contrast-enhanced axial T1-weighted MR image (422/9) obtained at same level as A shows that anterior part of lesion enhances intensely and inhomogeneously.

 


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  		Fig. 2C. —73-year-old man with glioblastoma. Lesion appears hyperintense and heterogeneous on axial diffusion-weighted MR image (b = 1000 sec/mm2).

 


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  		Fig. 2D. —73-year-old man with glioblastoma. Axial apparent diffusion coefficient (ADC) map of corresponding axial diffusion-weighted image (C) shows that those areas of enhancement appear isoto slightly hyperintense. One area of interest () is shown where ADC has been measured in enhanced solid part of tumor.

 


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  		Fig. 1E. —37-year-old man with low-grade oligodendroglioma. Photomicrograph of surgical specimen (5-µm thick) is diagnostic of low-grade oligodendroglioma. (H and E, x200)

 


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  		Fig. 2E. —73-year-old man with glioblastoma. Photomicrograph of surgical specimen (5-µm-thick) is diagnostic of glioblastoma. (H and E, x200)

 


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  		Fig. 1F. —37-year-old man with low-grade oligodendroglioma. Photomicrograph of surgical specimen with lmmunohistochemical staining shows high stain intensity (brown) of hyaluronan immunoreactivity. (Avidin-biotin-peroxidase complex with diaminobenzidine and H2O2, x 200)

 


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  		Fig. 2F. —73-year-old man with glioblastoma. Photomicrograph of surgical specimen with immunohistochemical staining shows low stain intensity (brown) of hyaluronan immunoreactivity corresponding to lower value of hyaluronan labeling index than in low-grade astrocytoma. (Avidin-biotin-peroxidase complex with diaminobenzidine and H2O2, x200)

 


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  		Fig. 3. —Graph shows representation of mean apparent diffusion coefficient (ADC) values (mean ADC tum x 10–5 mm2/sec) in low-grade and high-grade tumors. Low-grade tumors present with higher mean values of ADC than do high-grade tumors. ADCtum = ADC of tumor.

 


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  		Fig. 4. —Graph shows mean apparent diffusion coefficient (ADC) ratios (ADC of tumor–normal white matter) in low-grade and high-grade tumors. Similar results as in Figure 3 are found with low-grade tumors presenting with higher mean values of ADC ratio than do high-grade tumors.

 


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  		Fig. 5. —Graph shows measured labeling index of hyaluronan (LI-HA) in low-grade and high-grade tumors. Low-grade tumors present with higher mean values of LIHA than do high-grade tumors.

 


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  		Fig. 6. —Scatterplot shows positive correlation between mean apparent diffusion coefficient (ADC) values (x10–5 mm2/sec) and mean labeling index of hyaluronan (LI-HA). High-grade gliomas (•) can be distinguished from low-grade gliomas () (Kendall's rank correlation coefficient test, {tau} = 0.35, p < 0.05). ADCtum = ADC of tumor.

 

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